Impact of Computerized Decision Support on Blood Pressure Management and Control

A Randomized Controlled Trial

Computerized decision support in hypertension treatment leads to increased prescribing of recommended medication, but does not affect blood pressure control. Racial/ethnic disparities in blood pressure control were not affected by this intervention.

Measuring and improving the quality of hypertension care has become a national priority in recent years. This article looks at whether computerized decision support (CDS) can be an effective tool for improving care and reducing racial/ethnic disparities in hypertension care and outcomes. The researchers randomized 2,207 adult patients receiving hypertension care in 14 primary care practices to either 18 months of their physicians receiving CDS for each hypertensive patient or to usual care without computerized support for the control group. They assessed prescribing of guideline-recommended drug therapy and levels of blood pressure control for patients in each group and examined if the effects of the intervention differed according to the patient's race/ethnicity.

Key Findings:

  • CDS to physicians about hypertension treatment guidelines increased recommended medication prescribing compared to usual care.
  • Blood pressure control did not improve significantly.
  • The effectiveness of CDS intervention did not differ by the patient's race/ethnicity and mild disparities in blood pressure control persisted despite CDS.

The authors conclude that future work should focus on improvement of these interventions and the study of other practical interventions to reduce disparities in hypertension-related outcomes.